Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy

Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy Publisher Pubmed

Mohammadi M^{1, 3} ; Okanishi T¹ ; Okanari K¹ ; Baba S¹ ; Sumiyoshi H¹ ; Sakuma S¹ ; Ochi A¹ ; Widjaja E² ; Go CY¹ ; Otsubo H¹

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1. Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
2. Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
3. Department of Pediatric Neurology, Children's Medical Center, Tehran, Iran

Source: Brain and Development Published:2015

Abstract

Background: Generalized paroxysmal fast activity (GPFA) consists of burst of generalized rhythmic discharges; 100-200. μV; 1-9. s; 8-26. Hz; with frontal predominance; appearing during NREM sleep. GPFA was originally described as an electrographic feature of Lennox-Gastaut Syndrome (LGS). We analyzed GPFA on scalp video EEG (VEEG) in children to evaluate that GPFA presents in patients with intractable localization-related epilepsy. Methods: We collected cases with GPFA with intractable localization-related epilepsy who underwent scalp VEEG, MRI, and magnetoencephalography (MEG) prior to intracranial video EEG (IVEEG) and surgical resection. We collected 50 epochs of GPFA per patient during the first night during scalp VEEG. We analyzed amplitude, duration and frequency of GPFA over the bilateral frontal region between surgical resection side with grid placement and non-resection side. Results: We identified 14 (14%) patients with GPFA on scalp VEEG. The mean amplitude ranged from 145 to 589. μV (mean 293. μV). The mean duration ranged from 1.18 to 2.31. s (mean 1.6. s). The mean frequencies ranged from 9.3 to 14.7. Hz (mean 11.1. Hz). The amplitude (307. ±. 156. μV) and duration (1.62. ±. 0.8. s) of GPFAs in all the patients over the resection side were significantly higher than those (279. ±. 141. μV, 1.58. ±. 0.8. s) of the non-resection side (. p<. 0.001). All nine patients who showed significant duration differences between two hemispheres (. p<. 0.05) had longer duration of GPFA over the resection side. Eight of 12 patients who showed significant amplitude differences between two hemispheres (. p<. 0.05) had higher amplitude of GPFA over the resection side. Four of six patients who showed significant frequency differences between two hemispheres (. p<. 0.05) had higher frequency of GPFA over the resection side. Nine (64%) patients became seizure free after surgical resection including multilobar resections in eight patients. Conclusions: GPFA can exist in localization-related epilepsy with secondary bilateral synchrony. Although EEG shows GPFA on scalp VEEG, the precise localization of the epileptogenic zone using IVEEG could achieve the successful surgical resection. © 2014 The Japanese Society of Child Neurology.

Style	Citing Format
MLA	Mohammadi M, et al.. "Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy." Brain and Development, vol. 37, no. 1, 2015, pp. 59-65.
APA	Mohammadi M, Okanishi T, Okanari K, Baba S, Sumiyoshi H, Sakuma S, Ochi A, Widjaja E, Go CY, Otsubo H (2015). Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy. Brain and Development, 37(1), 59-65.
Chicago	Mohammadi M, Okanishi T, Okanari K, Baba S, Sumiyoshi H, Sakuma S, Ochi A, Widjaja E, Go CY, Otsubo H. "Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy." Brain and Development 37, no. 1 (2015): 59-65.
Harvard	Mohammadi M et al. (2015) 'Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy', Brain and Development, 37(1), pp. 59-65.
Vancouver	Mohammadi M, Okanishi T, Okanari K, Baba S, Sumiyoshi H, Sakuma S, et al.. Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy. Brain and Development. 2015;37(1):59-65.
BibTex	@article{ author = {Mohammadi M and Okanishi T and Okanari K and Baba S and Sumiyoshi H and Sakuma S and Ochi A and Widjaja E and Go CY and Otsubo H}, title = {Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy}, journal = {Brain and Development}, volume = {37}, number = {1}, pages = {59-65}, year = {2015} }
RIS	TY - JOUR AU - Mohammadi M AU - Okanishi T AU - Okanari K AU - Baba S AU - Sumiyoshi H AU - Sakuma S AU - Ochi A AU - Widjaja E AU - Go CY AU - Otsubo H TI - Asymmetrical Generalized Paroxysmal Fast Activities in Children With Intractable Localization-Related Epilepsy JO - Brain and Development VL - 37 IS - 1 SP - 59 EP - 65 PY - 2015 ER -

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